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Takeda and Millennium Oncology have begun a Phase III development programme for ixazomib citrate (MLN 9708), the first oral proteasome inhibitor to enter clinical trials for Multiple Myeloma and to be a possible successor to the Velcade. The trial is TOURMALINE-MM1 which will assess MLN 9708 in patients with relapsed and/or refractory Multiple Myeloma at sites in North and South America, Europe and the Asia-Pacific region. A once weekly dose will be administered in combination with lenalidomide and dexamethasone therapy and compared with placebo plus the latter two drugs against the primary endpoint of progression-free survival.Ixazomib has improved and broader activity and pharmacokinetics compared with Velcade which is intravenously administered whereas Ixazomib is orally administered.